How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Facility | None | $8.13 | $8.13 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.51 | Professional | None | $8.13 | $8.13 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.26 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.26 |
BCBS North Dakota Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $19.50 | Professional | None | $14.13 | $18.62 | $19.50 |
BCBS North Dakota Setting Professional Modifier 22 · Increased work Typical Low $16.98 Median $22.39 Typical High $23.44 | Professional | 22 · Increased work | $16.98 | $22.39 | $23.44 |
BCBS North Dakota Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.80 Typical High $3.89 | Professional | 55 · Aftercare only | $2.82 | $3.80 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $16.22 Typical High $20.42 | Professional | None | $11.48 | $16.22 | $20.42 |
Medica Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $24.55 | Facility | None | $8.13 | $8.13 | $24.55 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $16.22 Typical High $380.19 | Professional | None | $8.32 | $16.22 | $380.19 |
United Setting Professional Modifier None Typical Low $8.32 Median $14.45 Typical High $16.98 | Professional | None | $8.32 | $14.45 | $16.98 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $4.17 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.03 Median $6.03 Typical High $6.31 | Professional | 54 · Surgery only | $6.03 | $6.03 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.83 |
Where North Dakota sits
The same service costs 2.3 times more in Hawaii than in North Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
North Dakota· 5th of 51
$16.22
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.